MEDICARE: TAMARA ODEH KHEIR MHS, PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1376281279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA ODEH KHEIR MHS, PA-C

Provider Business Mailing Address
First Line	:	1097 ARCHES PARK DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-5648
Country	:	US
Telephone Number	:	702-465-5790
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 W PLANO PKWY STE 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8372
Country	:	US
Telephone Number	:	214-750-3646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2022
Last Update Date	:	05/22/2022

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